Objective To analyze the merger candida albicans pulmonary tuberculosis irfection risk factors, clinical characteristics,treatment and prognosis,ways of improving the coexistence of the two diseases in the early di-agnosis and treatment methods. Methods 86 cases with pulmonary tuberculosis combined candida albicans infection were analyzed. Results Pulmonary lung infection candida albicans no specific clinical manifestations, in addition to X-ray signs of tuberculosis,mainly for the merger under the shadow of lung flake fuzzy; prediction for risk factors: long-term use of broad-spectrum antibiotics, the multi-antibiotics, glucocorticoid or immunosuppreasanta, long-term bed rest, physical weakness, the length of hospitalization, chronic bronchitis and obstructive pulmonary disease (COPD), respiratory failure, mechanical ventilation, diabetes, hypoproteinemia, blood diseases, multiple organ failure,mechanical ventilation,and other invasive operation is closely related to a higher mortality rate of pulmonary fungal infections. Conclusion Active tuberculosis disease and therapy to reduce risk factors, prevention and early diagnosis of good,reasonable use of antibiotics,hormones,and so un,the key is to improve the cure rate.

e.

Objective To observe the effects of lower limb motion control training using virtual games combined with core stability training (CST) on the lower limb motor function of hemiplegic patients after stroke.Methods Sixty hemiplegic stroke patients were divided into an observation group and a control group (n =30 in each) using a random number table.The control group was given conventional treatment and CST,while the observation group received lower limb motion control training using virtual games in addition to conventional treatment and CST.All of the patients were assessed using the Fugl-Meyer lower limb assessment (FMA),the Berg balance scale (BBS),the modified Barthel index (MBI),10 metre maximum walking speed (MWS) and functional ambulation categorization (FAC)before and after 8 weeks of treatment.Results Before the intervention there was no significant difference between the two groups in any of the measurements.After the treatment,however,the average FMA,BBS,MBI,MWS and FAC in the observation group were significantly better than those before treatment and those in the control group.Conclusions Lower limb motion control training using virtual games combined with core stability training can improve effectively the lower limb motor function of hemiplegic patients after stroke.Such a combination is worth applying in clinical practice.

Objective To investigate the clinical characteristics of postoperative spondylodiscitis after lumbar intervertebral disc herniation.Methods 9 cases with spondylodiscitis were reviewed,about their clinical symptoms,laboratory tests,bacteria culture,CT and MRI finging,etc.Results and Conclusion The clinical symptoms occurred 8~24 d after operation.Laboratory test and MRI were helpful for the early diagnosis.The outcome of both surgical and non-surgical treatment was satisfactory.

Objective To observe the characteristics and treatment of malignant peripheral nerve sheath tumor originated from neurofibromatosis and the outcome of the patients. Methods A case was reported and the related literatures were reviewed. Results and Conclusion Malignant peripheral nerve sheath tumor is a rare soft tissue malignancy, which is with highly invasion. There are some difficulties with the diagnosis and treatment, and the outcome is poor. Early diagnosis is very important for treatment.

Objective To explore the strategy and outcomes of surgical treatment of thoracic ossification of ligamentum flavum(OLF),especially combined with ossification of posterior longitudinal ligament,thoracic kyphosis and epidural adhesion.Methods Fifty-three cases of thoracic OLF from January 2003 to December 2009 were reviewed retrospectively.All patients were treated by the methods of en bloc resection of semi-facet and lamina.All patients were followed up for more than half an year,including 32 males and 21 females,aged from 43 to 73 years(average 54.7 years).The lesions located in upper thoracic for 18 patients,and in thoracolumbar for 35 patients.For multi-level or jumping OLF patients,the responsible levels were determined by combination of images and clinical symptoms.For multi-level OLF with ossification of posterior longitudinal ligament(OPLL)or thoracic kyphosis(＞50°),multi-level pedicle screw fixation and correction of kyphosis were performed.For dural adhesion patients,part of cerebrospinal fluid was released with a caudal incision of dural sac resulting in collapse and epidural arachnoid separation.Ossific and adhesion dura mater were removed with integrity of arachnoid.The surgical outcomes were evaluated with preoperative and postoperative thoracic Japanese Orthopaedic Association(JOA)score,Nurick grade and neurologic functional recovery ratio.Results Fifty-three cases were followed up for 6 months to 6 years,with an average of 18 months.The average preoperative JOA score was 4.3±2.3,which significantly increased to 8.3±1.8 after operation.Postoperative neurologic functional recovery rates were 11% to 80%(average 65.8%),including excellent in 18 cases,good in 20,fair in 10,and poor in 5.The excellent or good rate was 71.7%.The mean preoperative Nurick grade was 3.7(2-5 grade)and decreased to 2.3 grade after operation.Conclusion En bloc resection of semi-facet and lamina is a safe and effective method for treatment of thoracic OLF.For the patients with OPLL or kyphosis,pedicle screws fixation and kyphosis correction was beneficial for recovery of neurologic function of thoracic OLF patients.

Objective:To explore the brain function changes in patients with cervical vertigo using functional MRI.Methods:Twenty-two patients who were diagnosed with cervical vertigo were recruited in this study for functional MRI (fMRI) analysis, while 25 age- and sex-matched adult healthy individuals were chose forhealthy controls. The Visual Analogue Scale(VAS) and Dizziness Handicap Inventory (DHI) were used to access the severity of cervical vertigo, and the six-point categorical rating scale was used to measure the frequency of vertigo. Functional MRI was used to investigate the regions with brain functional changes between the cervical vertigo group and the control group. All the data was analyzed using low-frequency oscillation amplitude (ALFF) to explore local brain function changes. The ALFF values between the two groups were tested by two independent samples t-tests. Finally, the ALFF values in abnormal brain regions were extracted using the REST software package and correlated with the diseaseduration of cervical vertigo and thevertigo scores (VAS and DHI) using Pearson correlation analysis. P <0.05 was considered statistically significant. Results:Compared to healthy controls, patients with cervical vertigo haddecreased ALFF valuesin the left superior temporal gyrus (voxel=45, t=-3.36), right superior temporal gyrus (voxel=32, t=-2.82) and left supramarginal gyrus (voxel=57, t=-4.85), and increased ALFF values in the left and right cerebellum (voxel=41, t=4.26; voxel=33, t=4.57; respectively)(AlphaSim Rest, all P values >0.05). The ALFF values of left and right superior temporal gyrus were negatively correlated with the disease duration of vertigo (left R2=0.437, right R2==0.259), the VAS score (left R2==0.453, right R2==0.341) and DHI score (left R2=0.553, right R2=0.594), respectively, and there were significant differences (all P values < 0.05). The ALFF values of left and right cerebellum were positively correlated with the disease duration of vertigo (left R2==0.555, right R2=0.490) and the VAS score (left R2=0.307, right R2=0.282) and DHI score (left R2=0.632, right R2=0.591), respectively, and the differences were significant (all P values < 0.05). Conclusion:Patients with cervical vertigo have reduced spontaneous nerve activity in bilateral Vestibular cortex, and increased spontaneous nerve activity in the bilateral cerebellum. The brain functional changes were correlated with the disease duration and the severity of vertigo.

BACKGROUNDInjectable three-dimensional (3D) scaffolds have the advantages of fluidity and moldability to fill irregular-shaped defects, simple incorporation of bioactive factors, and limited surgical invasiveness. Adipose-derived stem cells (ADSCs) are multipotent and can be differentiated toward nucleus pulposus (NP)-like cells. A hypoxic environment may be important for differentiation to NP-like cells because the intervertebral disc is an avascular tissue. Hence, we investigated the induction effects of hypoxia and an injectable 3D chitosan-alginate (C/A) gel scaffold on ADSCs.

METHODSThe C/A gel scaffold consisted of medical-grade chitosan and alginate. Gel porosity was calculated by liquid displacement method. Pore microstructure was analyzed by light and scanning electron microscopy. ADSCs were isolated and cultured by conventional methods. Passage 2 BrdU-labeled ADSCs were co-cultured with the C/A gel. ADSCs were divided into three groups (control, normoxia-induced, and hypoxia-induced groups). In the control group, cells were cultured in 10% FBS/DMEM. Hypoxia-induced and normoxia-induced groups were induced by adding transforming growth factor-β1, dexamethasone, vitamin C, sodium pyruvate, proline, bone morphogenetic protein-7, and 1% ITS-plus to the culture medium and maintaining in 2% and 20% O2, respectively. Histological and morphological changes were observed by light and electron microscopy. ADSCs were characterized by flow cytometry. Cell viability was investigated by BrdU incorporation. Proteoglycan and type II collagen were measured by safranin O staining and the Sircol method, respectively. mRNA expression of hypoxia-inducing factor-1α (HIF-1α), aggrecan, and Type II collagen was determined by reverse transcription-polymerase chain reaction.

RESULTSC/A gels had porous exterior surfaces with 80.57% porosity and 50-200 üm pore size. Flow cytometric analysis of passage 2 rabbit ADSCs showed high CD90 expression, while CD45 expression was very low. The morphology of induced ADSCs resembled that of NP cells. BrdU immunofluorescence showed that most ADSCs survived and proliferated in the C/A gel scaffold. Scanning electron microscopy showed that ADSCs grew well in the C/A gel scaffold. ADSCs in the C/A gel scaffold were positive for safranin O staining. Hypoxia-induced and normoxia-induced groups produced more proteoglycan and Type II collagen than the control group (P < 0.05). Proteoglycan and Type II collagen levels in the hypoxia-induced group were higher than those in the normoxia-induced group (P < 0.05). Compared with the control group, higher mRNA expression of HIF-1α, aggrecan, and Type II collagen was detected in hypoxia-induced and normoxiainduced groups (P < 0.05). Expression of these genes in the hypoxia-induced group was significantly higher than that in the normoxia-induced group (P < 0.05).

CONCLUSIONADSCs grow well in C/A gel scaffolds and differentiate toward NP-like cells that produce the same extracellular matrix as that of NP cells under certain induction conditions, which is promoted in a hypoxic state.

Adipose Tissue ; cytology ; Alginates ; chemistry ; Animals ; Cell Differentiation ; physiology ; Cells, Cultured ; Chitosan ; chemistry ; Glucuronic Acid ; chemistry ; Hexuronic Acids ; chemistry ; Rabbits ; Stem Cells ; cytology ; physiology ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry